RFI Browser

RFI # 1744:
Ack of paper claim

Informal
Formal

Submitter

Julia Dunicheva

Description

If 277CA (005010X214A1) is used to acknowledge a paper claim, how value of REF02 Bill Type Identifier in loop 2200D (REF01="BLT") should be formatted:
- can it mimic value from paper claim, i.e. have leading zero, for example "0111";
- or should it be sent without leading zero as for electronic claim, i.e. "111".

Response

The 277CA 005010X214 (there is no A1 Errata) is not intended to be used to acknowledge paper claims. Sections 1.4 – Business Usage and 1.7.1 – The Claim (837) indicate that the 277CA is in response to an 837 transaction submission and not paper claim submission.

The 005010X214 guide defines the 2200D Bill Type Identifier (REF02, where REF01=BLT) as the concatenated value of the Facility Type Code (CLM05-1) and the Claim Frequency Code (CLM05-3) of the 837. Since the CLM05-1 sub-element has a maximum of 2 bytes and CLM05-3 has a maximum of 1 byte, and to maintain consistency between the electronic transactions, the Bill Type Identifier in the 2200D of the 005010X214 would be reported as a 3 byte value (e.g. 111).